PO-04-049 PATIENT CHARACTERISTICS AND FIVE-YEAR CLINICAL OUTCOMES OF PATIENTS WITH HEART FAILURE WITH MID-RANGE EJECTION FRACTION.

Abstract

Clinical outcomes of patients presenting with heart failure and mid-range ejection fraction (HFmEF) between 35-50% is less defined. Cardiac risk factors are associated with increased risk of disease progression. To define patient clinical characteristics associated with worsening and improvement in cardiac function and clinical outcomes. Between July 2017 and December 2022, 250 patients (pts) were identified with newly diagnosed heart failure with HFmEF. Clinical characteristics, comorbidities, outcomes and prognosis among these pts who improved (Group-1: left ventricular ejection fraction (LVEF) >50%) remain stable (Group-2: LVEF 35-50%) and worsened (Group-3: LVEF <35%) were analysed. At a mean follow up of 55±6 months, LVEF improved in 146 (58.4%) pts, 69 pts (27.6%) remained stable and 35pts (14%) worsened. All pts were started on guideline directed optimal heart failure medication. At final follow up, in group 1, 9 (6.16%) had sustained Ventricular Arrhythmias VAs, none were hemodynamically significant VA, 8 (5.48%) needed ICD and 1 (0.68%) needed CRTD. Group 2, 16 (23.18%) had sustained VAs, 1 (1.45%) hemodynamically significant VA, 12 (17.39%) needed ICD and 4 (5.79%) needed CRTD. Group 3, 21 (60%) had sustained VAs, 5 (14.28%) hemodynamically significant VA, 16 (45.71%) needed implantable cardioverter defibrillator (ICD) and 5 (14.28%) needed cardiac resynchronisation therapy defibrillator (CRTD). Table 1 shows clinical characteristics of the three distinct subgroups and clinical outcomes. Mid-range cardiomyopathy is not a benign condition. Aggressive targeted treatment strategies should be embarked to improve outcomes. Careful monitoring and routine follow up needs to be undertaken. Diabetes, CAD, scar at baseline on MRI and VAs are adverse predictors of left ventricular function improvement and prognosis.